3 Foreword By the Government Chief Scientific Adviser ( ) This report sets out the conclusions of the Blackett Review looking at the issue of Biodetection. Blackett Reviews, which I started a few years ago, use both Government and non-government scientists to address problems that require scientific input of the highest level. We live in a world in which the UK is subject to threats and hazards from within and outside of the UK. One of the responsibilities of government is to address these threats using the best scientific thinking and technologies available to do so. A terrorist attack using biological agents is one of the highest impact risks within the National Security Strategy (NSS) and CONTEST (the Governments Counter-Terrorism Strategy). Government is therefore committed to accelerating scientific methods to detect biological threats at the earliest opportunity, in order to mount a rapid response and to minimise loss of life. This Blackett Review on wide area biological detection was commissioned by me at the request of the Home Office and MOD. The review uses internationally regarded experts from inside and outside Government to provide leading edge thinking on the best ways to rapidly detect a biological release. The report identifies a number of recommendations for further strengthening the UK s capability and explores routes for development over the short and medium term. Professor Sir John Beddington 3

5 1. Executive summary In Autumn 2012, at the request of Home Office (HO) and supported by the Ministry of Defence, the GCSA convened a Blackett Review to address the question Which technologies or capabilities could enable rapid, wide-area detection of a broad spectrum of biological agents in the next 15 years? As well as exploring the implications of rapid advances in the biological sciences over recent years, the review considered the contribution of broader scientific developments on the UK s ability to detect biological hazards. This report summarises the findings from the review. Specifically it highlights a number of technologies and capabilities that could enhance government s ability to detect and respond to an aerosolised biological attack in the next 15 years. Although advanced technologies will play a critical role in enhancing the UK s capability, the review concluded that the integration 1 of existing information sources and systems could significantly enhance the timeliness and effectiveness of a response in the short term. The review question was based on analysis over a 15 year timescale; however the panel concluded that there were significant opportunities in the short to medium term that justified focused consideration during the meetings. Whilst the review focused on the detection of a deliberate release of a biological agent, the Blackett panel concluded that the ability to rapidly detect unusual health signals would have significant benefits for public health, taking advantage of the opportunities afforded by nearuniversal coverage of the National Health Service. Such signals could give valuable early warning of influenza and other epidemics at an earlier stage than possible with current reporting systems. Many of these health benefits are achievable within the short term, but require decisive and co-ordinated government support. An effective response requires cross-government action. The ability to detect, report and respond to a biological attack or infectious disease outbreak will draw on the resources of several government departments. The successful delivery of a future wide-area biodetection system is critically dependent upon collaboration between the key departments and agencies, industry and academia. In addition, a number of areas of fundamental research are crucial to achieving the required levels of performance for an effective wide-area biodetection capability. It was not possible to cover the threat aspect of biodetection in detail during these meetings. Panel discussions therefore focused on the opportunities for Government to harness technologies and capabilities, shaped by the above question. 1 Information framework integrating signals from array of sensors, intelligence, public health/syndromic surveillance, veterinary, social networks/search engine queries and additional sources of information. 5

6 The following technical areas were specifically identified for action by the panel: Physical Processes Sensors Sequencing Alternative Information Sources and Statistics Systems Integration Information and Systems Integration A number of specific recommendations are made within each of the technical areas above and are captured within the relevant sections of this report. In addition, overarching recommendations are captured below. Clearly this work was not performed in isolation and supports the work that the Home Office, Ministry of Defence, Department of Health, Cabinet Office and others are doing to address many of the issues discussed in this report. 6

7 1.1 Recommendations Short term impact 2 : 1. Government should assess the feasibility of developing an automated biodetection reporting system. Such a system should integrate data from deployed sensors, public health, veterinary, intelligence and alternative information sources 3, with clear reporting lines, in order to improve the timeliness and effectiveness of a response to a biological attack or infectious disease outbreak. 2. The Government should work with Industry to understand the commercial and market drivers for biodetection and to assess the viability of solutions in a global competitive market. 3. The Government should work collaboratively across departments and agencies and in partnership with Industry, to assess the broader benefits of wide area biodetection systems for public, veterinary and plant health. 4. The Government should support systems engineering studies 4 to develop costed options for a network of wide-area biodetection capabilities within a 5 and 10 year timeframe. Studies should be informed by the findings from table-top exercises. 2 Benefit realised within 5 years 3 E.g. Social networks, search engine queries and other alternative signals from the internet. 4 Systems engineering is an interdisciplinary field of engineering focusing on how complex engineering projects should be designed and managed over their life cycles. 7

8 Medium term impact 5 : 1. Government Departments 6 should work collaboratively with other UK research funders, including UK Research Councils and the Technology Strategy Board, and with international partners to develop the underlying knowledge base and infrastructure for wide-area biodetection: Fundamental research: Characterisation of the aerosol microbiome in representative urban environments 7 Techniques for sample capture, concentration and preparation Statistical design of urban air sampling and sensing regimes 8 Enhanced metagenomics and bioinformatics for high confidence wide-area biodetection Techniques for high throughput sequencing Translational 9 research: Microinstrumentation for highly portable sensor networks Development of high throughput air sampling methodologies and equipment for widearea biodetection. Systems engineering studies 10 to optimise and cost system solutions Evaluation of the performance of dispersion models within priority biodetection scenarios Application of statistical and data analytics methods for the identification, integration and reporting of biodetection signals from vast datasets in real-time Identify and evaluate the most effective sources of alternative data /information in predicting, detecting and tracking the course of a biological attack 5 Benefit realised within 10 years 6 Government departments with an interest in biodetection include HO, MOD, DH, DEFRA, CPNI and BIS 7 A microbiome is the totality of microbes, their genetic elements (genomes), and environmental interactions in a particular environment. 8 To enhance probability of detection and reduce false alarm rates 9 Translational research is scientific research that facilitates the translation of findings from basic science to practical applications that enhance human health and well-being. 10 To develop a multi-layered staircase approach based on increasing information density and statistical certainty to establish the presence, characteristics, identity and confirmation of use of biological agents. 8

9 2. Introduction A terrorist attack using biological agents 11 is one of the highest impact risks within the National Security Strategy (NSS) and CONTEST (the Governments Counter-Terrorism Strategy). Such events could have a significant effect on human and animal health and on the economy. The early detection of a deliberate biological release is a critical component of a response to a biological attack, to enable timely responses, to restore normality and to minimise loss of life. 2.1 Technical challenges and aspiration If a biological warfare agent is released within an urban environment, there is a window of opportunity in which protective measures and treatment can minimise loss of life. A relatively small release of infectious agent could travel rapidly and affect a large area. Thus, to be effective and preserve life, a wide area biodetection capability should trigger an alert in real-time and initiate measures as quickly as possible. The capability also needs to link all of the command elements. Given the implications of an incident, Government response will be directed at the highest level; accordingly the indication of an event will require a very high level of associated confidence. Technical challenges include, but are not limited to the ability to: detect 'true' events in near real-time minimise 'false alarms' This requires an understanding of variations in the biological background in representative environments and statistical analysis to inform the location and density of sampling sites in urban locations. The significant costs associated with developing and deploying early warning systems for biological agents also presents a challenge. In order to provide a high confidence alert of a biological agent release to decision-makers, detection systems must meet stringent performance characteristics, the costs of which can prove prohibitively expensive for industry or government alone to develop and exploit. Experience to date in deploying wide-area biodetection systems in the US (see box 1) can inform the development of future biological detection systems for use in urban environments. 11 Viruses, bacteria and toxins 9

10 Box 1: US experience of wide area biodetection systems In January 2003 the US deployed a bio surveillance system ( BioWatch ) to provide persistent surveillance of a mass release of biological agents in more than 30 cities. The system cost the US approximately $1 million in initial equipment costs per city, followed by operational costs of $1 million per city per year 12. If the planned transition to Generation 3 is successful, the estimated annualised direct cost for acquisition and operation over 10 years is $200 million 13. It has been reported in the media that as of 2012, the system had generated a large number of false alarms, with more than 50 such cases documented between 2003 and State and local health officials have never ordered evacuations or distributed emergency medicines in response to a positive reading from the system 14. A review of the BioWatch programme by the National Research Council in the US recommended that the current system be replaced with a new biodetection system capable of more frequent, more rapid, and more comprehensive automated analysis and reporting of results. The review encouraged testing of any future concept in realistic environments to establish its effectiveness. It also advocates collaboration with public health systems to improve its usefulness 15. An aspiration for government is to develop and deploy an affordable persistent wide area biological detection capability able to rapidly detect, identify and locate a deliberate release of aerosolised biological material(s) over a wide area. No single technology or approach will currently achieve all of these goals. 12 "Nationwide Monitoring System Planned For Detecting Bioterror Attack," The Associated Press, January 22, BioWatch and Public Health Surveillance: Evaluating Systems for the Early Detection of Biological Threats: Surveillance/Biowatch%202010%20Report%20Brief.pdf 10

11 2.2 Review format This Blackett review was convened to take a fresh look at the technical challenges for biodetection and consider how rapid developments in biological science 16 and beyond may enable a step change in the UK s wide-area biological detection capability. The review specifically asked: Which technologies could enable rapid, wide area detection of a broad spectrum of biological agents in the next 15 years? The first meeting of the panel consisted of a morning of background presentations and demonstrations by experts within government followed by an afternoon discussion session, chaired by the GCSA. There were two follow-up meetings, each about six weeks apart, to identify and discuss key issues and potential solutions that Government should take forward. A summary of the panel discussions, key findings and specific recommendations are described below. The recommendations result from meetings of sub-groups in four key areas, highlighted by the panel as having significant potential for impact: Physical processes Sequencing Alternative Information Sources and Statistics Systems Integration Specific recommendations are highlighted in bold at the end of each section. 16 industrialization_bio_natl_security.pdf 11

12 3. Sensing system 3.1 System design The release of a biological agent leads to two main specific events: The physical presence of the agent in the environment Changes in the health status of exposed individuals, livestock or other biological targets, leading to the identification of associated symptoms by clinicians Sensing systems are concerned with the identification of the physical presence of the agent in the environment. The aim of a wide-area biodetection sensing system is to gather as much information as possible to provide accurate and confident reporting of the presence of a biological threat agent in the environment, with the secondary benefit of potentially narrowing the extent of the hazard as quickly as possible. There are considerable challenges associated with using physical methods for the rapid detection and definitive identification of biological agents in the natural and built environment. These derive both from the complex nature of the biological threat itself and from the natural background which is a complex, fluctuating mix of organic and inorganic matter 17. A multi-faceted series of actions with defined timelines are therefore required in response to a natural or deliberate exposure to biological agents. The event timeline comprises the following steps. 1. persistent (24/7) real-time environmental monitoring, 2. preliminary characterisation of the agent, 3. area delineation and confirmation of the identity of the agent. This review recommends that a decentralised and networked array of sensors is required to trigger rapid and reliable alarms and to define the nature of the event (origin, agent type and direction of travel) and the geographical perimeter of exposure. Ideally, such detectors should have dual use applicability to drive economies of scale and efficiency to include treatment (public health), warning (national security), prosecution (law enforcement) and intent (intelligence). To achieve this goal a multi-layered staircase approach to wide-area detection is proposed. Here technologies are viewed not singly but as grouped into a system such that each step descended on the staircase results in an increase in both the quantity of information and the statistical certainty associated with the detection event. 17 Stetzenbach, L.D., Buttner, M.P. & Cruz, P. (2004) Detection and enumeration of airborne biocontaminants. Curr. Opin. Biotech. 15,

17 A significant challenge to exploiting generic physico-chemical characterisation of bioaerosols lies in the development of field portable instrumentation. However, new developments, particularly in miniaturised Time-of-flight mass spectrometry (TOF-MS), Nuclear Magnetic Resonance (NMR) and Raman Spectroscopy are likely to provide a robust, yet enhanced analytical capability suitable for use within a decentralised network of sensors. Developments within this area are promising and should be assessed further for use within a wide area biodetection scenario. Unmanned vehicles have been used by both military and civilian first responders operating in potentially hostile environments to discern information about their local physical environment in real-time. There are only a limited number of unmanned ground vehicles (UGVs) and unmanned air vehicles (UAVs) that carry chemical sensors and none are equipped with biosensors. Micro Air Vehicles (MAVs) could be introduced in these settings, with control and guidance operated from a smartphone 41. Smartphone-guided MAVs equipped with inexpensive microengineered physico-chemical sensors thus may provide an opportunity for exploring local air space in cities, towns, buildings and sensitive assets for the detection and localisation of biological and chemical agents. Figure 4 An integrated systems approach incorporating sample collection, preparation and analysis 41 Cummings, M.L., Jackson, K., Quimby, P. & Pitman, D. (2012) Int J Micro Air Vehicles 4,

18 In order to achieve high confidence detection over a wide area and against a variable background, the sensing system will require effective and efficient aerosol sampling, sample pre-processing (collection, purification, concentration and amplification of the pathogen, or components of the pathogen) and delivery methodologies. The implementation of a fully integrated system of hardware 42, wetware 43 and associated software 44 and infoware 45 would ensure decisions are taken at each level of certainty. 42 The collectors, machined parts, sensors, (opto) electronics, power supplies, microprocesors, communications network 43 The biological sample, reagents, consumables, biochemical and sequencing systems 44 Communication and control software required to implement the functions in figure 5 45 The information collected from each module, sensor or device and the fusion of numerous data streams into a reliable, quality, quantitative format that is unambiguously and effectively communicated to the end user 18

19 3.3 Sequencing Sequencing, the process of determining and then reading the genome of an organism, offers significant applicability for wide area biodetection in the short to medium term. Sequencing a genome for example provides a bar-code of very high precision that can be used to identify a biological threat organism, trace its origins and predict its capacity to cause disease. Within the last five years, there has been a step change in the speed, costeffectiveness and ease with which DNA sequences can be determined, thanks to a clutch of new technologies which fall under the umbrella term of high-throughput sequencing. Technological innovations, together with strong commercial competition, have resulted in year on year improvements that outpace the often cited Moore s law, which describes exponential improvements in the performance of computers. The increasing speed of analysis, coupled with the high level of precision means genome sequencing is seen as being at the heart of any future wide area detection system. In the context of a system, sequencing would be used to analyse samples derived direct from environmental sources and not simply the genome of a single organism. Box 3: Metagenomics The application of high throughput sequencing to DNA extracted from complex microbial communities or environments is known as metagenomics. Metagenomics delivers genome-scale sequence data from multiple organisms en masse, without prior culture in the laboratory. Where multiple genomes are present there is an increase in the complexity of both sequencing and the consequent analysis of that genomic information. However, the application of sequencing technological and informatics approaches to these meta genome samples has received substantial interest in a range of contexts from environmental to clinical microbiology. Whilst lagging slightly, the study of airborne biological material is a rapidly developing discipline with clear implications for wide-area detection. Consequently there is now ample evidence in the scientific literature as to the utility of sequencing for the characterisation of the microbial content of airborne environments. 46,47,48 46 Bowers, R. M., Lauber, C. L., Wiedinmyer, C., Hamady, M., Hallar, A. G., Fall, R, Knight, R. & Fierer, N. (2009). Characterization of Airborne Microbial Communities at a High-Elevation Site and Their Potential To Act as Atmospheric Ice Nuclei. Appl Environ Microbiol 75, Bowers, R. M., McLetchie, S., Knight, R. & Fierer, N. (2011). Spatial variability in airborne bacterial communities across land-use types and their relationship to the bacterial communities of potential source environments. ISME J 5, Tringe, S. G., Zhang, T., Liu, X. et al., (2008). The Airborne Metagenome in an Indoor Urban Environment. PLoS ONE 3, e

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